FIGURE 1.7 Estimated percentage of infants born to women living with HIV receiving a virological test by 2 months of age, by UNICEF region, all low- and middle-income countries and the 22 Global Plan priority countries, 2010–2012 2010
2011
2012
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
Eastern and Southern Africa
West and Central Africa
Middle East and North Africa
East Asia and the Pacific
South Asia
Latin America and the Caribbean
CEE/CIS
All low- and middle-income countries
22 Global Plan countries
Note: The vertical lines indicate the uncertainty ranges around the estimates.
INITIATIVES
Source: UNAIDS, UNICEF, WHO, 2013 Global AIDS Response Progress Reporting, and UNAIDS 2012 HIV and AIDS estimates.
Presumptive diagnosis in Lesotho Where early infant diagnosis is weak, severe illness can progress quickly in children with HIV. Presumptive diagnosis allows health workers to offer immediate ART to infants showing signs of HIV-related disease. In some areas of Lesotho, for example, difficult terrain leads to long waits for the return of HIV test results, and also makes it difficult to keep test kits in stock. Delivery of infant HIV test results can take 6 to 12 weeks, delaying the start of life-saving treatment for infants who need it. Presumptive diagnosis eliminates this wait by relying on immediate assessment rather than laboratory test outcomes as the basis for ART initiation. In 2010, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) supported Lesotho’s Ministry of Health in training maternal and child health nurses at three hospitals in presumptive diagnosis. Between January 2010 and December 2011, the specially trained nurses diagnosed 48 infants with severe HIV disease and started ART promptly. Of these 48 children, 43 received a test for HIV. When their test results arrived, 42 of them proved to be living with HIV and 1 was HIV-negative. EGPAF intends to train more health-care workers in the WHO presumptive diagnosis criteria. A recommendation for scale-up in Lesotho has been made, while efforts to improve routine systems for EID are also intensifying.
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